Marco Pacori

Psychologist-Psychotherapist, Italy
The consequences of mandatory wearing of masks during developmental
age.

The mask has become a symbol of the change in social habits since the
Italian Government decided to imposed its use in March 2020 with the law
decree of ‘’Cura Italia’ (Care Italy).
Without entering the debate of the effectiveness, efficiency, health issues
due to the possible side effects of this accessory, it should be emphasized that
nothing has been said about the psychological impact of the mask, especially for
children.
To start with some with some preliminary considerations: the mask
covers a large part of the face, preventing the recognition, interpretation and
imitation of facial expressions. According to the most eminent scholars of the
branch of psychology known as "body language", facial expression is one of the
most important aspects of human communication.8,9,10,11 (Ekman, P. 1970,
Friesen, Ekman, P. & Friesen, W. V., 1971.W. V., & Tomkins, S. S Ekman, P.,
1972.Ekman P. 1972). The face is not only responsible for sharing thoughts and
ideas, but above all for emotions.
This mimicry is innate and universal, but its understanding must be
"trained" with interpersonal interactions 16 (Mariska Kret, 2015)
Brain imaging Investigations have shown that the perception of facial
expressions in adults is processed by a circuit consisting of three cortical areas:
the fusiform gyrus (FG) 13 (Ishai A, 2010), the occipital face area (OFA) and
the superior temporal sulcus (STS); moreover, this circuit is connected with the
amygdala (the emotional brain) and the orbitofrontal cortex (the cognitive
region) 14 (Jiang Y, Shannon RW, Vizueta N, Bernat EM, Patrick CJ, He S.
2008). However, this does not apply to children. During childhood these areas
only appear "sketchy", whereas these connections are more or less non-existent
at birth and evolve with the growth and being in society.
The Wearing of "bridles"(mask) during exchanges with other children
during school time, not only causes a sort of emotional illiteracy 3 (Capps L,
YirmiyaN, Sigman M et alt, 1992), but also causes an irreversible reduction in
the volume of the areas mentioned .
Therefore the consequences, are dramatic: most of all, because this condition
follows what is found in those suffering from autism spectrum disorders 11, 15
(Harms MB, Martin A, Wallace GL, 2010; Loth E, Garrido L, Ahmad et al,
2018)): in essence, the use of the mask causes a "functional autism" 2, 4, 12, 17
(Baron-Cohen S; Herba C, Phillips M, 2004; Celani G, Battacchi MW,
Aridiacono, 1999; Pelphley KA, Sasson NJ, Reznick et al. 2002).
The face not only communicates emotions or intentions, but predominately
identity. Because it is so be able to distinguish a face and its features that there
is a specific area in the human brain which is there exclusively for this task (on
important point is that; if we look at a car or a mobile phone, it is not activated).
This area is called the FFA (facial fusiform area) 14 (Kanwisher N, Yovel
G) Since it is an area of the brain which evolves during the age of development.
If during this phase of development the face is covered by a mask for most of
the time (the hours spent at school with class friends and teachers), the risk is
that it atrophies with the consequence that the child or boy will no longer be
able to distinguish one face from another, or to create an image of himself, to be
able to recognize the traits that distinguish the gender: in practice, the young
person will grow up asexual, without identity and without the ability to
understand who he is dealing with.
The habit of wearing the mask will therefore induce 5 (Dalrymple KA,
Corrow S, Yonas A et al. 2012), a usually congenital perceptual deficit known
as prosopagnosia 19, 20 (Pizzamiglio MR, M De Luca M, Di Vita A et al.,
2017, De Luca, M., Pizzamiglio, MR, Di Vita, A., Palermo et al., 2019)
These "disabilities" caused by the prolonged use of a mask during the age of
development inevitably results in the child being unable to develop the basic
values of social life, such as empathy, sincerity, altruism, solidarity, trust,
fidelity, love, etc. that is, the fragments that together constitute the spirit of
aggregation and the formation of bonds: from friendship, to the group, to the
first "blow" and to the most important nucleus on which human society is based:
the family. Children denied identity and the ability to express and understand
emotions, in turn will be unable to create, their own family and this will cause
an unraveling of the entire social fabric.

Bibliografia:

1. Baron-Cohen S. Autism: the empathizing-systemizing (E-S) theory. Ann N Y Acad Sci.

2009;1156:68 – 80
2. Capps L, Yirmiya N, Sigman M. Understanding of simple and complex emotions in non-
retarded children with autism. J Child Psychol Psychiatry. 1992;33:1169 – 82.
3. Celani G, Battacchi MW, Arcidiacono L. The understanding of the emoziona meaning of facial
expressions in people with autism. J Autism Dev Disord. 1999;29:57–66.
4. Dalrymple KA, Corrow S, Yonas A, Duchaine B. Developmental prosopagnosia in childhood.
Cogn Neuropsychol. 2012;29(5-6):393-418
5. Ekman, P. (1970). Universal Facial Expressions of Emotions. California Mental Health
Research Digest, 8(4), 151-158.
6. Ekman, P. & Friesen, W. V. (1971). Constants Across Cultures in the Face and Emotion.
Journal of Personality and Social Psychology, 17(2) , 124-129.
7. Ekman, P., Friesen, W. V., & Tomkins, S. S. (1971). Facial Affect Scoring Technique: A First
Validity Study. Semiotica, 3, 37-58.
8. Ekman, P. (1972). Universals and Cultural Differences in Facial Expressions of Emotions. In
Cole, J. (Ed.), Nebraska Symposium on Motivation (pp. 207-282). Lincoln, NB: University of
Nebraska Press.
9. Grill-Spector K, , Knouf N, Kanwisher N: The fusiform face area subserves face perception,
not generic within-category identification; Fac Comparative Study-Nat Neurosci 2004
May;7(5):555-62.
10. Harms MB, Martin A, Wallace GL. Facial emotion recognition in autism spectrum disorders: a
review of behavioral and neuroimaging studies. Neuropsychol Rev. 2010;20:290–322.
11. Herba C, Phillips M: Annotation: Development of facial expression recognition from
childhood to adolescence: behavioural and neurological perspectives; The Journ of Child
Psychol and Psychiatry, Volume 45, Issue7, Oct 2004; 1185-1198
12. Ishai A: Seeing faces and objects with the "mind's eye".Arch Ital Biol. 2010 Mar;148 (1):1-9.
13. Jiang Y, Shannon RW, Vizueta N, Bernat EM, Patrick CJ, He S. Dynamics of processing invisible
faces in the brain: automatic neural encoding of facial expression information. Neuroimage.
2009;44(3):1171-1177. doi:10.1016/j.neuroimage.2008.09.038
14. Kanwisher N, Yovel G: The fusiform face area: a cortical region specialized for the perception
of faces. Philos Trans R Soc Lond B Biol Sci. 2006 Dec 29;361(1476):2109-28.
15. Loth E, Garrido L, Ahmad J Watson E , Duff A , B Duchaine B: Facial expression recognition
as a candidate marker for autism spectrum disorder: how frequent and severe are deficits?
Mol Autism, 2018 Jan 30;9:7
16. Mariska E. Kret, Emotional expressions beyond facial muscle actions. A call for studying
autonomic signals and their impact on social perception, Frontiers of Psy, 2015
17. Pelphrey KA, Sasson NJ, Reznick JS, Paul G, Goldman BD, Piven J. Visual scanning of faces in
autism. J Autism Dev Disord. 2002;32:249 – 61
18. Neuropsychol Rehabil
19. Pizzamiglio MR, M De Luca M, Di Vita A, Palermo L et al.: Congenital prosopagnosia in a
child: Neuropsychological assessment, eye movement recordings and training; Neuropsychol
Rehabil, 2017 Apr;27(3):369-408.
20. De Luca, M., Pizzamiglio, M. R., Di Vita, A., Palermo, L., Tanzilli, A., Dacquino, C., & Piccardi, L.
(2019). First the nose, last the eyes in congenital prosopagnosia: Look like your father looks.
Neuropsychology, 33(6), 855–861
21. Rhodes G, Byatt G, Michie PT, Puce A: Is the fusiform face area specialized for faces,
individuation, or expert individuation? J Cogn Neurosci. 2004 Mar;16(2):189-203
22. Wingenbach TSH, Ashwin C. Brosnan: diminished sensitivity and specificità at recognising
facial emotion expressions of varying intensity underlie emotion-specific recognition deficits
in autism spectrum disorders. Res Autism Spectr Disord. 2017;34:52 – 61.
23. Wang Q. DiNicola L, Heymann P, Hampson M, Chawarska K: mpaired Value Learning for
Faces in Preschoolers With Autism Spectrum Disorder; J Am Acad Child Adolesc Psychiatry,
2018 Jan;57(1):33-40.